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Cary Adult Home
7336 Cary Avenue
Gloucester, VA 23061
(804) 693-7035

Current Inspector: Willie Barnes (757) 439-6815

Inspection Date: Sept. 2, 2020 , Nov. 2, 2020 and Jan. 21, 2021

Complaint Related: Yes

Areas Reviewed:
22VAC40-73 ADMISSION, RETENTION, AND DISCHARGE OF RESIDENTS

Comments:
The inspection was conducted by licensing staff using an alternate remote protocol, necessary due to a state of emergency health pandemic declared by the Governor of Virginia.
A complaint inspection was initiated on 9-2-20 and concluded on 1-21-21. A complaint was received by the department in areas of administration and administrative services. The administrator was contacted by telephone to conduct the investigation. The licensing inspector emailed the administrator a list of documentation required to complete the investigation.
The evidence gathered during the investigation did not support the allegations of non-compliance with standards of law. Any violation not related to the complaint but identified during the course of the investigation can be found on the violation notice.

Violations:
Standard #: 22VAC40-73-390-A
Complaint related: Yes
Description: Based on document review and staff interview, the facility failed to ensure at or prior to the time of admission, there shall be a written agreement/acknowledgement of notification that included all of the information required by the regulation.

Evidence:


Evidence:
1.A review of the resident agreement provided by the facility indicated the following:
a- Item I.D (Financial Arrangements) documented, ??non-refundable deposit is required in order to reserve a room?. Facility accepts auxiliary grant residents and auxiliary grant residents may not be charged an advance payment or deposit payment.
b- Item I.H documented, ? ?facility charges a variable rate for HDTV cable and TV rental..? There is no listing of specific charges, including the frequency of payment, and any rules relating to nonpayment.
c- Item I.O documented, ?facility reserves the right to charge a minimum of $25 per trip and in addition up to $1.00 per mile?. The resident agreement did not include documentation as to which trips the residents would be charged for.
d- Item I.Q. documented, ?facility deducts from client fund/personal account money for medication expenses and money to satisfy overpayment of SSI, delayed payments and damage to facility property, tv services. Resident funds for auxiliary grant residents cannot be used to pay rent if there is a delayed payment. The agreement does not specify the charges for damages to facility property, nor tv services.
e - Item II.A. (Client Account/Funds) documented facility provides client monthly statements, unless facility is responsible for managing the client?s financial affairs has been delegated to the facility, in which case the Facility agrees to provide a stated of the client account quarterly.
f - Item II.C. documented personal funds made available to client/ and or responsible party upon request with at least 10-day advance notice.
g ? Item II.D. documented, upon client?s demise, balance become property of Tricare, Inc.
h - III.A. (Client Rules of Conduct) document, immediate dismissal follow-up written notice given within 24 hours.
2. Staff #2 acknowledged the resident agreement did not include all required regulatory requirements.

Plan of Correction: Resident agreement document revised to include all regulatory requirements

Disclaimer:
A compliance history is in no way a rating for a facility++.

The online compliance history includes only information after July 1, 2003. In addition, the online compliance history includes information regarding adverse actions that may be the subject of a pending appeal. An adverse action is not final until a provider has exhausted or waived all due process rights. For compliance history prior to July 1, 2003, or information regarding the status of pending adverse actions, please contact the Licensing Inspector listed in the facility's information. The Virginia Department of Social Services (VDSS) is not responsible for any errors in or omissions from the compliance history information.

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